A H Beck Foundation Company

• Document No.

• PROJECT NAME

• AHB PROJECT NUMBER

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel on worksite

AHB SUPERINTENDENT

PERSONAL PROTECTIVE EQUIPMENT

• Hard hats (with bills forward)

  Yes

  No

  N/A

• Safety glasses appropriate for conditions (tinted or clear)

  Yes

  No

  N/A

• Hard toe work boots

  Yes

  No

  N/A

• Reflective vests

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Hearing protection if required

  Yes

  No

  N/A

• Face shields for cutting or grinding

  Yes

  No

  N/A

HOUSEKEEPING

• General site storage and housekeeping

  Yes

  No

  N/A

• Trash cans in work area

  Yes

  No

  N/A

• Spoil piles maintained

  Yes

  No

  N/A

• Storage / Dog House orderly

  Yes

  No

  N/A

• Safe walkways or passages

  Yes

  No

  N/A

TEMPORARY BARRICADES

• Proper tape used (red for danger, yellow for caution)

  Yes

  No

  N/A

• All sides of work area barricaded and labeled

  Yes

  No

  N/A

LADDERS AND ELEVATED WORK

• Ladders tied off

  Yes

  No

  N/A

• Ladder extended 3'

  Yes

  No

  N/A

• Inspected and tagged

  Yes

  No

  N/A

• Components undamaged

  Yes

  No

  N/A

• Handrail in place

  Yes

  No

  N/A

FALL PROTECTION

• Harness and lanyards used

  Yes

  No

  N/A

• Harness and lanyards inspected and within useable life

  Yes

  No

  N/A

• Hole protection used during work hours

  Yes

  No

  N/A

• Proper hole protection used after hours

  Yes

  No

  N/A

MOBILE EQUIPMENT

• Equipment inspected prior to initial use each shift

  Yes

  No

  N/A

• Seatbelts used

  Yes

  No

  N/A

• Workers trained

  Yes

  No

  N/A

• Annual inspections as required

  Yes

  No

  N/A

• Backup alarms working

  Yes

  No

  N/A

• Spotters used when needed

  Yes

  No

  N/A

• Equipment maintained without leaks

  Yes

  No

  N/A

• Safety guards and covers in place

  Yes

  No

  N/A

• Whip-checks used on pressurized lines

  Yes

  No

  N/A

• Spill kits available

  Yes

  No

  N/A

HOISTING AND RIGGING EQUIPMENT

• Daily crane inspection performed

  Yes

  No

  N/A

• Annual inspection placard and operators manuals available

  Yes

  No

  N/A

• Proper rigging and techniques used

  Yes

  No

  N/A

• Sling/chokers properly stored

  Yes

  No

  N/A

• Slings/chokers inspected

  Yes

  No

  N/A

• Qualified rigger named

  Yes

  No

  N/A

• Safety latch on hook checked

  Yes

  No

  N/A

• Workers staying clear of suspended loads

  Yes

  No

  N/A

• Knowledge of crane signals

  Yes

  No

  N/A

• Proper use of tag lines on suspended loads

  Yes

  No

  N/A

• Swing protection in place

  Yes

  No

  N/A

EXCAVATION

• Shaft stability measures properly used (casing, fluid level maintained, drill mud within specs, etc)

  Yes

  No

  N/A

• Spin off area maintained

  Yes

  No

  N/A

• Equipment staged a safe distance away overnight

  Yes

  No

  N/A

• Workers trained

  Yes

  No

  N/A

REBAR PLACEMENT

• Lifting plan properly planned, communicated and managed by a designated lift supervisor

  Yes

  No

  N/A

• Cage properly prepared with #9 wire and clamps

  Yes

  No

  N/A

• Cage properly rigged for lifting

  Yes

  No

  N/A

• Cage lifted and secured in shaft safely

  Yes

  No

  N/A

CONCRETE OPERATIONS

• Concrete pump and hoses used properly

  Yes

  No

  N/A

• Slick lines and hoses properly clamped with safety wire

  Yes

  No

  N/A

• Concrete washed from skin contact

  Yes

  No

  N/A

PREWORK

• Weekly Toolbox Talks are relevant to the Project, and sign-in sheets are submitted

  Yes

  No

  N/A

• Safe Work Plan was communicated to all workers on the project for tasks performed

  Yes

  No

  N/A

• MSDS for all chemicals on the project are available upon request

  Yes

  No

  N/A

• Supervisors are aware of local first-aid and hospital facilities

  Yes

  No

  N/A

• All required jobsite work permits, hot work permits, excavation permits, etc are obtained and dated properly.

  Yes

  No

  N/A

• Underground locates are in place and current

  Yes

  No

  N/A

• First Aid Kit is on site, in a sanitary condition and available for all workers on the Project

  Yes

  No

  N/A

• Employee training records are available for work being performed

  Yes

  No

  N/A

REPRIMANDS OR WARNINGS

• We're any reprimands issued?

  Yes

  No

• We're any verbals warnings or directives given?

  Yes

  No

• Was any Stop Work order issued?

  Yes

  No

COMMENTS

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INSPECTION PERFORMED BY:

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